Active NPI
Kimberlyn Kellogg, DC
- Chiropractor
- Murfreesboro, TN
National Provider Identifier
1255483855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2043
- Practice address
- 1535 W Northfield Blvd
Suite 6
Murfreesboro, TN 37129-1427 - Phone
- (615) 887-6868
- Fax
- (615) 849-7744
- NPI assigned
- Jan 17, 2007
- Last updated
- Jun 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2043 | TN | Primary |
Addresses
Primary practice location
1535 W Northfield Blvd
Suite 6
Murfreesboro, TN 37129-1427
Mailing address
5054 Tabitha St
Murfreesboro, TN 37129-2878
Phone (615) 887-6868
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4129293 | Other | TN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2043 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gordon C. Johnson | Chiropractor | Past | Accepting new patients |
| Mitchell Stanlick, D.C., LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371686400000",
"number": "1255483855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5054 TABITHA ST",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371292878",
"telephone_number": "615-887-6868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1535 W NORTHFIELD BLVD",
"address_2": "SUITE 6",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371291427",
"telephone_number": "615-887-6868",
"fax_number": "615-849-7744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLOGG",
"first_name": "KIMBERLYN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2013-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "2043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4129293",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.